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1902874415 NPI number — MARY ELISABETH BATES A.R.N.P.

NPI Number: 1902874415
Health Care Provider/Practitioner: MARY ELISABETH BATES A.R.N.P.

Information about “1902874415” NPI (MARY ELISABETH BATES A.R.N.P.) exists in 1902874415 in HTML format HTML  |  1902874415 in plain Text format TXT  |  1902874415 in PDF (Portable Document Format) PDF  |  1902874415 in an XML format XML  formats.

NPI Number : 1902874415 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902874415",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BATES",
    "FirstName": "MARY",
    "MiddleName": "ELISABETH",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "A.R.N.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1708 YAKIMA AVE STE 205",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TACOMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98405-5300",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-565-5307",
    "MailingAddressFaxNumber": "360-782-3040",
    "FirstLinePracticeLocationAddress": "1628 S MILDRED ST",
    "SecondLinePracticeLocationAddress": "#104",
    "PracticeLocationAddressCityName": "TACOMA",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98465-1628",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-565-6777",
    "PracticeLocationAddressFaxNumber": "253-565-8777",
    "EnumerationDate": "03/09/2006",
    "LastUpdateDate": "12/01/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "AP30004223",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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